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HC-EH IC EOC ROUNDING CLINICAL AREAS

GENERAL INFORMATIONDate 11/16/2023Time 12:37Institution Mid CitiesInstitution ID
295Building Name Mid CitiesDepartment NursingFloor 3Unit/Area 3rd floor patient
careAuditor Jessica NwachukwuAdditional AuditorsCori Harris, Katherine
HeathCLEANLINESS AND STORAGEAre patient transport gurneys and wheelchairs clean?
YesAre EVS closets clean? YesAre EVS closets secure? YesAre hospital approved
disinfectant available? YesAre mats intact and clean? NoMats condition
imageCorrected During InspectionHas high level dusting been completed? YesAre
hallways clean and uncluttered? YesIs equipment kept to one side of the hallway?
YesAre ceiling tiles clean? NoNo.: 00564Date: 11/16/2023HC-EH IC EOC Rounding
Clinical AreasSubmitted by Jessica Nwachukwu at 11/16/2023 13:56 EST Page:
1Captured at 11/16/2023 13:55 EST gocanvas.comSubmission ID:
15F8C963-5720-47E1-8A6C-0D7845642B0D

Ceiling tile imageAre doors able to swing fully open (no
proppeddoors/wedges)?YesAre corrugated cardboard boxes removed? NoCorrugated
cardboard boxes imageCorrugated cardboard boxes notesFound in Quest labNo.:
00564Date: 11/16/2023HC-EH IC EOC Rounding Clinical AreasSubmitted by Jessica
Nwachukwu at 11/16/2023 13:56 EST Page: 2Captured at 11/16/2023 13:55 EST
gocanvas.comSubmission ID: 15F8C963-5720-47E1-8A6C-0D7845642B0D

Are floors clean, and free trash of boxes? YesIs food in refreshment area stored
in labeled bags? YesIs the microwave and refreshment area clean? NoMicrowave and
refreshment area imageCorrected During InspectionIs the medication prep area
clean and organized? NoMedication prep area imageNo.: 00564Date: 11/16/2023HC-EH
IC EOC Rounding Clinical AreasSubmitted by Jessica Nwachukwu at 11/16/2023 13:56
EST Page: 3Captured at 11/16/2023 13:55 EST gocanvas.comSubmission ID:
15F8C963-5720-47E1-8A6C-0D7845642B0D

Medication prep area notesFound in med room cabinets from WOW drawers;
discardedCorrected During InspectionIs patient information in public view (i.e.,
charts,computer terminals)?YesPatient information in public view notesPatient
labels and information found in drawers and cabinets. Discarded
appropriatelyCorrected During InspectionDo storage units have solid bottoms?
YesAre storage units, bins, and shelving clean? YesAre supplies 6 inches above
the floor and 18 inchesbelow the ceiling?YesIs only appropriate storage located
under the sink? YesAre supplies stored where food is consumed? NoIs clean
equipment stored separately from soiledequipment?YesIs the Clean Utility Room
clean and organized? YesIs the Dirty Utility Room labeled, clean, and secured?
YesIs hazardous waste disposed of appropriately? YesDo biohazard bins have lids?
YesAre oxygen tanks kept 5 feet away from anycombustible items?YesAre more than
12 full oxygen tanks stored together? NoAre empty oxygen tanks properly labeled?
YesAre Peg/NG irrigation sets stored dry? YesEXPIRED MEDS, SOLUTIONS, AND
SUPPLIESAre vacutainer tubes expired? NoAre irrigation fluids labeled,
discarded, and not expired? YesAre multi-dose vials expired? NoAre medications
expired? YesExpired medications imageCorrected During InspectionAre open
drugs/spiked IVs labeled per policy? NoNo.: 00564Date: 11/16/2023HC-EH IC EOC
Rounding Clinical AreasSubmitted by Jessica Nwachukwu at 11/16/2023 13:56 EST
Page: 4Captured at 11/16/2023 13:55 EST gocanvas.comSubmission ID:
15F8C963-5720-47E1-8A6C-0D7845642B0D

Open drugs/spiked IVs imageOpen drugs/spiked IVs notesOpen drugs in pill cutters
found in WOWs; discarded appropriatelyCorrected During InspectionAre solutions
expired? YesExpired solutions notesGlucometer solutions without dates;
discardedCorrected During InspectionAre patient supplies expired? NoAre sterile
items labeled with the name visible? YesIs food in storage expired?
NoREFRIGERATORIs the food in the patient refrigerator/freezer labeled,dated, and
covered?NoNo.: 00564Date: 11/16/2023HC-EH IC EOC Rounding Clinical
AreasSubmitted by Jessica Nwachukwu at 11/16/2023 13:56 EST Page: 5Captured at
11/16/2023 13:55 EST gocanvas.comSubmission ID:
15F8C963-5720-47E1-8A6C-0D7845642B0D

Food in patient refrigerator/freezer imageAre patient refrigerators clean,
rubber seals ok, and noice build-up in the freezers?NoPatient refrigerators
imageCorrected During InspectionIs there expired food in patient refrigerators?
NoNo.: 00564Date: 11/16/2023HC-EH IC EOC Rounding Clinical AreasSubmitted by
Jessica Nwachukwu at 11/16/2023 13:56 EST Page: 6Captured at 11/16/2023 13:55
EST gocanvas.comSubmission ID: 15F8C963-5720-47E1-8A6C-0D7845642B0D

Are medication refrigerator temperatures recordeddaily?YesIs the medication
refrigerator clean/defrosted? YesIs food stored in the medication refrigerator?
NoGENERAL IC PRACTICESAre food, drinks, and cosmetics located in patient
careareas, including nurses' station?NoAre personal lotions located in patient
care areas? NoIs PPE disposed of in patient rooms? YesAre PPE cabinets
appropriately stocked? YesIs PPE appropriately used? YesIs hand hygiene
performed before and after patientcare?YesAre soap and paper towels present in
the sink area? YesAre clean linen carts covered, with the door shut? YesDo linen
carts have a barrier on the bottom shelf? YesIs the dirty linen hamper more than
3/4 full? NoIs dirty linen covered? YesAre crash cart dates current? YesAre
crash carts checked according to policy? YesAre sharps containers secured?
YesAre sharps containers more than 3/4 full? NoDo foley bags hang below the
bladder, and not on thefloor?YesAre clean and dirty activities performed in
separate,clearly distinct areas?YesIs there visible mildew in any room? NoAre
there visible ants or insects? NoADDITIONAL CONCERNSAre there any additional
comments, concerns, orpictures related to this space?YesAdditional NotesOpen
supplies found in supply drawer behind nurses’ station and in nursing station
drawersNo.: 00564Date: 11/16/2023HC-EH IC EOC Rounding Clinical AreasSubmitted
by Jessica Nwachukwu at 11/16/2023 13:56 EST Page: 7Captured at 11/16/2023 13:55
EST gocanvas.comSubmission ID: 15F8C963-5720-47E1-8A6C-0D7845642B0D

Additional ImageSCOREAuditor ConfirmationCleanliness and Storage Correct
24.00Cleanliness and Storage Answered 30.00Cleanliness and Storage Score
80.00Expired Meds, Solutions, and Supplies Correct 6.00Expired Meds, Solutions,
and Supplies Answered 9.00Expired Meds, Solutions, and Supplies Score
66.67Refrigerator Correct 4.00Refrigerator Answered 6.00Refrigerator Score
66.67General IC Practices Correct 19.00General IC Practices Answered
19.00General IC Practices Score 100.00Therapy Gym Correct 0.00Therapy Gym
Answered 0.00Therapy Gym Score 0.00Pool Therapy Correct 0.00Pool Therapy
Answered 0.00Pool Therapy Score 0.00Total Compliant 53.00Total Answered
64.00Total Score 82.81No.: 00564Date: 11/16/2023HC-EH IC EOC Rounding Clinical
AreasSubmitted by Jessica Nwachukwu at 11/16/2023 13:56 EST Page: 8Captured at
11/16/2023 13:55 EST gocanvas.comSubmission ID:
15F8C963-5720-47E1-8A6C-0D7845642B0D

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